This study analyses the deterioration of mechanical properties in lightweight concrete after exposure to room temperature (20 °C) and high temperature, i.e., up to 1000 °C, including changes in visual appearance, loss of mass, and compressive strength. All-lightweight shale ceramsite aggregate concrete (ALWAC) and semi-lightweight shale ceramsite aggregate concrete (SLWAC) are prepared using an absolute volume method to analyse the relationships between relative ultrasonic pulse velocity, loss rate of compressive strength, damage degree, and temperature levels. Our results show that, under high temperature, the lightweight aggregate ceramsite concrete performs better compared to normal concrete. After exposure to 1000 °C, the ALWAC shows a strength loss of no more than 80%, while the normal concrete loses its bearing capacity, with a similar strength loss as the SLWAC. Furthermore, the relative ultrasonic pulse velocity and damage degree are used to evaluate the effects of high temperature on the concretes, including the voids and cracks on the surface and inside of the specimens, which induces the deterioration of mechanical properties and contributes to the thermal decomposition of the cementing system and the loss of cohesion at the aggregate interface. Based on internal structure analyses, the results from this study confirm that the lightweight aggregate concrete shows a high residual compressive strength after exposure to the high temperature.